RESUMEN
BACKGROUND: Auricular reconstruction is 1 of the biggest challenges of facial plastic surgery. The aim of this study was to evaluate the efficacy of 1-stage reconstruction of an auricle using a temporoparietal fascia flap (TPFF). METHODS: In this nonrandomized study, autologous auricle bodies with emergency condition and cartilaginous graft from projection of a costal arch from the VI-VII ribs were used. Temporal fascia sample with vascular pedicle (a temporal artery with the accompanying veins) by the Z-shaped incision of skin in temporal area for auricular reconstruction was extracted. Skin grafts were taken from the supraclavicular area or from the left or right flank. Grafts of partial auricle bodies (n = 8) along with cartilaginous framework from a costal arch (n = 21) were used for auricle reconstruction. The follow-up period studied after 6 months in 29 operated patients. RESULTS: The graft of partial auricle bodies or the graft of a cartilaginous framework from a costal arch presented a perfect auricular reconstruction. By avoiding a difficult microsurgery and its possible complications, the use of TPFF led to beneficial results in 75% and 90.4% of cases, respectively. Overall, no major complication (alopecia, hematoma, or necrosis) occurred, and further surgery was not required. CONCLUSION: TPFF is a technique of choice for surgical treatment of traumatic auricle defects.
RESUMEN
BACKGROUND: Management of asthma in chronically affected patients is a serious health problem. Our aim was to show that surgical treatment of chronic bronchial asthma by unilateral resection of the internal branch of the superior laryngeal nerve (ib-SLN) is an adequateand lasting remedial response. PATIENTS AND METHODS: In a retrospective study, 41 (26 male and 15 female) patients with bronchial chronic asthma were treated surgically during the period between 2005 and 2013. It consisted of a unilateral resection of the ib-SLN under optical zoom, on patients placed in supinator position. 35 patients (24 male and 11 female) who were un-operated were included as a control. RESULTS: In all patients, medication was reduced progressively. When the results were compared with the control group, it was seen that in 26% of the patients, both forced expiratory volume (FEV) and peak expiratory flow (PEF) increased significantly (p <05) and only modestly in 53.6% of patients (FEV, p <05 and PEF, p <05). In the remaining 20% of patients, these parameters remained however unchanged. Overall, in 80% of patients unilateral resection of the ib-SLN gave satisfactory results because it shortened the intervals and duration of asthmatic attacks, rendering thereby a reduction in medication. CONCLUSION: This minimal-invasive method helped prevent/cure asphyxias in chronic bronchial asthma without affecting cough reflex,respiratory control and phonation and it helped patients avoid severe crisis. This approach is of interest for patients with severe and/or uncontrolled bronchial asthma in settings with limited access to drug treatment.